| NPI | 1225240278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 5023) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: RI Pt00521) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: 000010369) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2007-07-08 |